Utilization Review Manager - Home Care jobs in Mesa, AZ

Utilization Review Manager - Home Care ensures quality and level of care for patients are up to established standards and comply with federal, state, and local regulations. Investigates and resolves reports of inappropriate care. Being a Utilization Review Manager - Home Care may require a bachelor's degree. Typically reports to a head of a unit/department. To be a Utilization Review Manager - Home Care typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)

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RN Utilization Review Case Manager
  • Actalent
  • Tempe, AZ OTHER
  • Hiring a RN UR Case manager for a full remote opportunity with hospital!! MUST HAVE Current CA RN Licensure, InterQual experience, EPIC Experience and at least 2 years of experience! Amazing team!

    M-F day shift with being open to rotating weekends.

    Description:

    This position facilitates utilization management (UM) processes to support that the right care is provided at the right place and at the right time. To accomplish these goals, he/she applies established criteria to evaluate the appropriateness of admission, level of care, continued hospitalization, and readiness for care transition; assures timely movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care delays/issues as necessary; in collaboration with the Facility Acute Care Manager (CM). This position provides third-party payers clinical information to assure reimbursement; and coordinating care with the treatment team, patient, family and others as necessary.

    Additional Skills & Qualifications:

    • Current CA RN Licensure

    • InterQual experience

    • EPIC Experience

    • 2 years of experience

    • Recent acute hospital case management experience preferred

    Experience Level:

    Intermediate Level

    About Actalent

    Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

    Diversity, Equity & Inclusion

    At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

    • Hiring diverse talent
    • Maintaining an inclusive environment through persistent self-reflection
    • Building a culture of care, engagement, and recognition with clear outcomes
    • Ensuring growth opportunities for our people

    The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

    If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

  • 6 Days Ago

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Utilization Review Nurse
  • Oscar Health
  • Tempe, AZ FULL_TIME
  • Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Clinical Review team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serv...
  • 22 Days Ago

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Home Health RN Case Manager - East Valley
  • Select Home Care
  • Chandler, AZ FULL_TIME
  • About us Select Home Care, LLC is a Phoenix Area Home Health Agency, with a focus on Adult Geriatric visit based care Registered Nurse Case Manager Duties:- Provide comprehensive nursing care to patie...
  • 8 Days Ago

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Caregivers for In-Home Care Agency
  • Family Home Care
  • Gilbert, AZ FULL_TIME
  • COMPETITIVE PAY, FLEXIBLE HOURS, AND 24/7 SUPPORT Join our Caregiving Team! Hiring immediately! We are currently looking for compassionate and dependable caregivers available to care for our clients i...
  • 9 Days Ago

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Client Care Coordinator (Home Care/Bilingual)
  • Emblem Home Care
  • Mesa, AZ FULL_TIME
  • JOB DESCRIPTION Senior Service Compliance Officer / Patient Care Coordinator Reports to: Director of Operations Work Hour: Full Time Position FLSA Status: Exempt Prepared By: Director of Operations Pr...
  • 2 Days Ago

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Patient Care Coordinator (Home Care/Bilingual)
  • Emblem Home Care
  • Chandler, AZ FULL_TIME
  • JOB DESCRIPTION Service Compliance Officer / Patient Care Coordinator Reports to: Director of Operations Work Hour: Full Time Position FLSA Status: Exempt Prepared By: Director of Operations Proposed ...
  • 2 Days Ago

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0 Utilization Review Manager - Home Care jobs found in Mesa, AZ area

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Supervisor, Utilization Management (RN Required) - Remote
  • TriWest Healthcare
  • Phoenix, AZ
  • Job Summary We offer remote work opportunities (AK, AR, AZ, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE,NV, NM, NC, N...
  • 3/28/2024 12:00:00 AM

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Full Time Hunting Team Lead
  • Cabela's
  • Mesa, AZ
  • **_POSITION SUMMARY:_** Under the supervision of the Group Sales or Department Manager, the Team Leader gives daily dire...
  • 3/28/2024 12:00:00 AM

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Store Manager (Bilingual)
  • Community Choice Financial Family Of Brands
  • Mesa, AZ
  • Who We Are: To continue providing even more financial solutions and rewarding career opportunities to support the commun...
  • 3/28/2024 12:00:00 AM

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Project Manager
  • EPS
  • Gilbert, AZ
  • Overview: As a NETA accredited independent electrical testing & engineering organization, we set the standard for techni...
  • 3/28/2024 12:00:00 AM

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Senior Project Manager
  • Southland Industries
  • Tempe, AZ
  • Job Description POSITION SUMMARY As a Senior Project Manager at Southland, we are looking for people who can be the sing...
  • 3/28/2024 12:00:00 AM

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Strategic Execution Director - Portfolio of Operations Strategic Initiatives Across Business Areas
  • US Bank
  • Tempe, AZ
  • At U.S. Bank, we're on a journey to do our best. Helping the customers and businesses we serve to make better and smarte...
  • 3/25/2024 12:00:00 AM

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Accreditation Coordinator (Utilization Management Department) - REMOTE
  • TriWest Healthcare
  • Phoenix, AZ
  • Job Summary We offer remote work opportunities (AK, AR, AZ, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE,NV, NM, NC, N...
  • 3/24/2024 12:00:00 AM

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Operations Manager
  • Allied Universal
  • Tempe, AZ
  • Overview Allied Universal® Janitorial Services is uniquely capable and personally committed to delivering exceptional ja...
  • 3/7/2024 12:00:00 AM

Mesa (/ˈmeɪsə/ MAY-sə) is a city in Maricopa County, in the U.S. state of Arizona. It is a suburb located about 20 miles (32 km) east of Phoenix in the East Valley section of the Phoenix Metropolitan Area. It is bordered by Tempe on the west, the Salt River Pima-Maricopa Indian Community on the north, Chandler and Gilbert on the south along with Queen Creek, and Apache Junction on the east. Mesa is the largest suburban city by population in the United States, the third-largest city in Arizona after Phoenix and Tucson, and the 36th-largest city overall in the US. The city is home to 496,401 pe...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Manager - Home Care jobs
$75,126 to $95,781
Mesa, Arizona area prices
were up 2.2% from a year ago